Citation Nr: 9916544
Decision Date: 06/16/99 Archive Date: 06/21/99
DOCKET NO. 97-03 709A ) DATE
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On appeal from the
Department of Veterans Affairs Regional Office in Detroit,
Michigan
THE ISSUE
Entitlement to benefits pursuant to the provisions of
38 U.S.C.A. § 1151 for residuals of a laryngeal injury as the
result of Department of Veterans Affairs treatment.
REPRESENTATION
Appellant represented by: The American Legion
ATTORNEY FOR THE BOARD
R. A. Caffrey, Counsel
INTRODUCTION
The veteran served on active duty from March 1964 to March
1966. This is an appeal from a September 1996 rating action
by the Department of Veterans Affairs (VA) Regional Office,
Detroit, Michigan, which denied entitlement to benefits
pursuant to the provisions of 38 U.S.C.A. § 1151 for
residuals of a laryngeal injury as a result of VA treatment.
REMAND
The record reflects that the veteran has been found to be
permanently and totally disabled for disability pension
purposes as the result of several conditions, including
residuals of squamous cell cancer of the larynx. He has also
been found entitled to the aid and attendance benefit. The
veteran has not established service connection for any
disability.
The record reflects that when the veteran was hospitalized by
the VA during August and September 1984 he reported an
intermittent hoarseness and the diagnoses included possible
leukoplakia of the vocal chords. He was again hospitalized
by the VA in October 1985 and vocal chord stripping was
performed.
When the veteran was examined by the VA in May 1990 his
complaints included hoarseness. It was indicated that cancer
of the larynx had been discovered in April 1990 and that he
had been on radiation treatment for that condition for
several weeks.
The regional office thereafter received VA outpatient
treatment records dated in 1991 and 1992 reflecting that an
esophogram in September 1992 was normal.
The veteran was afforded a VA general medical examination in
May 1993; however, there were no detailed findings regarding
the throat.
The regional office later received a number of VA inpatient
and outpatient treatment records dated from 1990 to 1996.
The records include the report of a laryngoscopy and biopsy
conducted in April 1990. A VA outpatient treatment record
dated in June 1990 reflects that the veteran had received
radiation treatment during May and June 1990. There is also
a report of the veteran's hospitalization in June 1991 when a
diagnosis was made of history of cancer of the epiglottis.
There is also a report of a September 1992 laryngoscopy with
vocal chord stripping and multiple biopsies. When the
veteran was hospitalized from August to October 1995 the
final diagnoses included chondroradionecrosis of the larynx,
status post carcinoma of the larynx and status post radiation
therapy. There is also a VA medical records treatment folder
with copies of the veteran's treatment in 1992. However,
some of the VA medical records were provided by the veteran
or his representative and the records may not be complete.
There are also reports by the United States Air Force at
Wright-Patterson Air Force Base reflecting that the veteran
was receiving hyperbaric oxygen therapy for radiation injury
composed of chondroradionecrosis of the larynx and radiation
esophagitis.
The veteran has maintained that during his radiation therapy
there was no protective covering over his larynx and vocal
chords. He has maintained that he had sustained bone
deterioration under his gums from the radiation treatment by
the VA in 1990 and that he still has redness and swelling in
his throat that causes constant problems.
On the basis of the present record, the Board is of the
opinion that additional information would be desirable and
the case is REMANDED for the following action:
1. The regional office should obtain the
veteran's complete VA inpatient and
outpatient treatment records folders and
associate those folders with the claims
file.
2. The veteran should then be afforded
special ear, nose and throat and dental
examinations in order to determine the
current nature and extent of any residual
disability from his laryngeal cancer.
Any indicated special studies should be
conducted. The examiners should express
opinions as to whether the veteran has
any additional disability resulting from
treatment of his laryngeal cancer
including the radiation therapy. The
claims file is to be made available to
the examiners for review in conjunction
with the examinations.
3. The veteran's claim should then be
reviewed by the regional office. If the
denial is continued, the veteran and his
representative should be sent a
supplemental statement of the case and be
afforded the appropriate time in which to
respond.
When the above action has been completed, the case should be
returned to the Board for further appellate consideration, if
otherwise in order. No action is required of the veteran
until he receives further notice.
The purpose of this REMAND is to obtain clarifying
information. The Board intimates no opinion as to the
disposition warranted in this case pending completion of the
requested action.
ROBERT D. PHILIPP
Member, Board of Veterans' Appeals
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals. This remand is in the nature of a
preliminary order and does not constitute a decision of the
Board on the merits of your appeal. 38 C.F.R. § 20.1100(b)
(1998).